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Abstrak :
ABSTRACT
Background: the aging process causes decreasing in the function of various organs. Skletal muscle is one of the organs affected by aging process. It is known as sarcopenia. Sarcopenia is defined as a syndrome characterized by progressive loss of muscle mass and strength. The handgrip strength examination is often applied as a sarcopenia filtering technique. This study aimed to determine the relationship between age, nutritional status, and chronic diseases such as stroke, hypertension (HT), diabetes mellitus (DM), coronary heart disease (CHD), and chronic obstructive pulmonary disease (COPD) with handgrip strength. Methods: a cross-sectional study to determine factors related to the handgrip strength in elderly patients was conducted in Geriatric outpatient clinic of Cipto Mangunkusumo Hospital and Mohammad Hoesin Hospital from August to October 2015. There were 352 eligible subjects in this study recruited with consecutive sampling. The independent variables in the study consisted of age, sex, nutritional status, chronic disease (stroke, hypertension (HT), diabetes mellitus (DM), coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD)), waist circumference while the dependent variable was handgrip strength. Results: age of more than 75 years old and malnutriton were risk factors that affected hangrip strength. Age of >75 years increase the risk for having low handgrip strength by 2,3-fold. Malnutrition increased risk for low handgrip strength for 1,9-fold. Conclusion: ages of >75 years old and malnutrition will increase the risk of low handgrip strength in elderly patients.

Abstrak :
ABSTRAK
Latar Belakang: : Peningkatan populasi usia lanjut di Indonesia diiringi dengan meningkatnya masalah kesehatan pada populasi tersebut, yang merupakan salah satu dampak proses menua. Dampak serius proses menua terjadi pada otot rangka, yaitu terdapat penurunan massa dan kekuatan otot yang disebut sarkopenia. Kekuatan otot lebih berperan dari massa otot sebagai prediktor hendaya dan mortalitas, sehingga penilaian kekuatan otot menjadi penting. Kekuatan genggam tangan dapat mewakili keseluruhan kekuatan otot dan pemeriksaannya sederhana, murah, serta mudah dilakukan. Berbagai faktor yang mempengaruhi kekuatan genggam tangan, faktor IMT dan lingkar pinggang masih kontroversi dan faktor penyakit kronik terhadap kekuatan genggam tangan belum pernah diteliti sehingga perlu diketahui faktor-faktor apa saja yang berhubungan dengan kekuatan genggam tangan. Tujuan: Mengetahui hubungan antara: usia, jenis kelamin, lingkar pinggang, status gizi dan penyakit kronik (DM, HT, stroke, PJK, PPOK) dengan kekuatan genggam tangan pada pasien usia lanjut. Metode: Penelitian potong lintang dilakukan bulan Agustus 2015 di poliklinik geriatri RSCM Jakarta dan RSMH Palembang . Subjek adalah pasien usia lanjut berusia  60 tahun, yang kontrol rutin. Pemeriksaan meliputi anamnesis, pengukuran lingkar pinggang, lingkar lengan, lingkar betis, tinggi lutut, berat badan, dan kekuatan genggam tangan. Uji analisis Cochran Mantel Haenzel digunakan untuk menilai faktor-faktor yang berhubungan dengan kekuatan genggam tangan pada penelitian ini. Hasil: Dari 352 subjek ,didapatkan jenis kelamin terbanyak perempuan 212(60,2)% rerata usia 69,7 (SB 6,3) tahun, rerata lingkar pinggang 90,6 (SB10,7), Status gizi yang terbanyak adalah status gizi normal (86,4%), komorbiditas tertinggi hipertensi (44,3%), rerata kekuatan genggam tangan perempuan 19,8 (SB 5,1) dan laki=laki 29,1 (SB 6,9). Terdapat usia (p=<0,001, PR=3,6) dan status gizi /MNA (p<0,001, PR=2,8) berhubungan dengan kekuatan genggam tangan Simpulan: Faktor yang berhubungan dengan kekuatan genggam tangan pada usia lanjut adalah usia dan status gizi

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ABSTRACT
Background: The increasing of the elderly population in Indonesia is accompanied by increasing health problems in the population, which is one of impact of the aging process. Serious affect of the ageing process is occured in skeletal muscle. There is a decreasing of mass and muscle strength, called sarcopenia. Muscle strength is more instrumental than muscle mass as predictors of mortality and frailty status, so assessment of muscle strength becomes important. Handgrip strength can represent the overall muscle strength.The examination of handgrip strength is simple, inexpensive, and easy to do. There are many determinand factors that can influence handgrip strength. Body mass index and waist circumference still on controversy. Chronic diseases is still not observed yet. This aim of this research is to obtain determinant factors that can influence handgrip strength in elderly. Objective : To obtain association of age, gender, waist circumference, nutrional status, and chronic disease with handgrip strength in elderly patient Methods: This cross sectional study was conducted to elderly outpatient age 60 years or above who visited Geriatric Clinic Cipto Mangunkusumo Hospital Jakarta and Mohammad Hoesin Hospital Palembang in August 2015. Data of age, gender, nutritional status, chronic diseases, waist circumference, arm circumference, calf circumference, and handgrip strength were collected. Cochran Mantel Haenzel was used to obtain determinant factors of handgrip strength Results: 352 subjects were recruited in this study. women which the most subject were 212 (60,2%), average of age was 69,7 years old (SB 6,3), average of waist circumference was 90,6 (SB 10,7), the most nutritional status was normal (86,4%), the highest comorbidity was hyptertension (44,3%), and average of handgrip strength were 19,8 (SB 5,1) in women and 29,1 (SB 6,9) in men. Determinant factors of handgrip strength were age (p=<0,001, PR=3,6) and nutritional status (p<0,001, PR=2,8). Conclusions: Determinand factors of handgrip strength were comorbidity (hypertension, diabetes mellitus, stroke, coronary heart disase, chronic obstructive pulmonary disease), nutritional status, and increasing of age;;

Abstrak :
Latar belakang. Penyakit ginjal kronik-gangguan mineral tulang (PGK-GMT) adalah komplikasi dari penyakit ginjal kronik (PGK) yang dapat meningkatkan risiko gangguan kardiovaskular pada anak. Salah satu kelainan pada PGK-GMT adalah hiperfosfatemia dan gangguan otot skeletal. Sebuah studipada pasien dewasa didapatkan korelasi negatif antara kadar fosfat yang dengan kekuatan genggaman tangan. Sampai saat ini belum ada penelitian yang menilai kekuatan genggaman tangan pada anak PGK G3-G5 di Indonesia dan faktor lain yang memengaruhi. Tujuan. Mengetahui faktor-faktor yang memengaruhi kekuatan otot melalui pemeriksaan kekuatan genggaman tangan pada anak PGK G3-G5. Metode. Penelitian ini merupakan uji potong lintang terhadap 72 anak PGK G3-G5 usia 6-18 tahun diRSCM dan pemilihan anak dilakukan secara consecutive sampling. Variabel yang dianalisis adalah pemeriksaan massa otot, lingkar lengan atas (LILA), serum fosfat, hemoglobin (Hb), neuropati, dan kekuatan genggaman tangan menggunakan dinamometer hidrolik tangan (JAMAR, Japan). Hasil. Median usia adalah 14 (11-16) tahun dengan lelaki 52/72 (72,2%). Penyebab terbanyak PGKadalah congenital anomalies of the kidney and urinary tract (CAKUT) 30/72 anak (41,7%) yang diikuti dengan glomerulonefritis 18/72 anak (25%). Median massa otot, LILA dan kekuatan genggaman tangan adalah 25,3 (18,7-32,9) kg, 19 (16-22) cm dan 8,65 (7,8-9,3) kg. Rerata kadar Hbdan fosfat adalah 10,45 (±1,72) g/dL dan 5,45 (± 1,92) mg/dL. Prevalens gangguan kekuatan genggaman tangan pada anak PGK G3-G5 adalah 98,6%. Pada penelitian ini tidak didapatkan korelasi antara kekuatan genggaman tangan dan kadar fosfat (r= -0,03; p= 0,42). Namun, didapatkan korelasi antara massa otot, LILA, dan kadar Hb terhadap kekuatan genggaman tangan yaitu (r = 0,70; p<0,01), (r = 0,68; p<0,01),dan (r = 0,44; p<0,01). Simpulan. Kekuatan genggaman tangan memiliki korelasi kuat dengan massa otot dan LILA serta memiliki korelasi cukup dengan kadar Hb. ......Background. Chronic kidney disease-bone mineral disorders (CKD-BMD) is a complication of chronic kidney disease (CKD) which may increase the risk of cardiovascular disease in children.Hyperphosphatemia and skeletal muscle disorder are one of the abnormalities in CKD-MBD. Study in adult population shows there are negative correlation between phosphate levels and hand grip strength.There has been no study for CKD G3-G5 in pediatric population regarding handgrip strength and other factors that correlate to it. Aim. To determine the factors that affect muscle strength through hand grip strength examination in children with CKD G3-G5 Methods. This is a cross-sectional study of 72 pediatric CKD G3-G5 aged 6-18 years old in RSCM.The subject was selected by consecutive sampling. The variables that we analyzed are muscle mass,mid-upper arm circumference (MUAC), serum phosphate, Hb, neuropathy, and hand grip strength usinghydraulic hand dynamometer (JAMAR, Japan). Results. The median age of the subjects was 14 (11-16) years old with 52/72 (72.2%) male. The most common causes of CKD are CAKUT with 30/72 subjects (41.7%) followed by glomerulonephritis with 18/72 subjects (25%). The median muscle mass, MUAC, and handgrip strength are 25,3 (18,7-32,9) kg, 19 (16-22) cm, and 8.65 (7.8-9.3) kg. Mean Hb level and phosphate level are 10.45 (±1.72) g/dL and 5.45 (±1.92) mg/dL. The prevalence of handgrip strength disorders in CKD G3-G5 is 98.6%. In this study, we found no correlation between handgrip strength and phosphate levels (r= -0.03; p= 0.42). However, we found positive correlation between muscle mass, MUAC, and Hb levels with handgrip strength (r= 0,70; p<0,01), (r = 0.68; p<0.01), and (r = 0.44; p<0.01). Conclusion. There is a correlation between muscle mass, MUAC, and Hb level with handgrip strength in pediatric CKD G3-G5.

Abstrak :
Kekuatan otot adalah salah satu tanda vital yang dapat menentukan risiko fungsi fisik serta risiko mortalitas. Laju penurunan kekuatan otot terjadi lebih cepat dibandingkan dengan laju penurunan massa otot. Kami menghubungkan salah satu faktor yang dapat memengaruhi penurunan kekuatan otot dengan fase awal diabetes, yang juga terkait dengan resistensi insulin. Tujuan penelitian ini untuk mengetahui hubungan nilai HOMA-IR dengan kekuatan relatif genggaman tangan pada wanita dewasa di Jakarta. Kami menggunakan metode cross sectional dan diperoleh 68 subjek. Data diperoleh melalui handgrip dynamometry, sampel darah, food recall 3 x 24 jam, pengukuran antropometri, dan kuesioner aktivitas fisik. Median nilai HOMA-IR 2,765 (0,62 – 6,12). Rerata kekuatan absolut genggaman tangan 25,32 ± 2,27 kg. Hasil kekuatan relatif genggaman tangan melalui perhitungan kekuatan absolut genggaman tangan dibagi berat badan diperoleh median 0,39 (0,22 – 0,61). Hasil uji statistik regresi linier dengan metode Enter menunjukkan tidak ada asosiasi yang signifikan antara HOMA-IR dengan kekuatan relatif genggaman tangan setelah dikontrol dengan IMT sebagai faktor perancu. ......Muscle strength is one of the vital signs that can determine the risk of physical function and overall mortality. The rate of decline in muscle strength occurs faster than the rate of decline in muscle mass. We relate one of the factors that can influence the decrease in muscle strength to the early phase of diabetes, which is also associated with insulin resistance. We aim to determine the association between HOMA-IR value and relative hand grip strength in adult women in Jakarta. We used a cross-sectional method and obtained 68 subjects. Data were obtained through handgrip dynamometry, blood samples, 3 x 24 hours food recall, anthropometric measurements, and IPAQ-SF questionnaires. The HOMA-IR value was obtained with a median of 2.765 (0.62 - 6.12). An average of 25.32 ± 2.27 kg resulted from absolute hand grip strength. While the results of the relative handgrip strength are dividing the absolute handgrip strength by body weight, a median of 0.39 (0.22 - 0.61) was obtained. The linear regression statistical test using the Enter method showed no significant relationship between HOMA-IR and relative hand grip strength after controlling for BMI as a confounding factor.

Abstrak :
Latar Belakang: Laparotomi merupakan pembedahan mayor yang dapat menyebabkan penurunan massa otot rangka dan kapasitas fungsional, seperti kekuatan genggam tangan (KGT). Berbagai studi membuktikan penurunan KGT pascaoperasi menimbulkan komplikasi pascaoperasi, serta KGT berkorelasi erat dengan appendicular skeletal muscle index (ASMI). Pengaruh ASMI praoperasi terhadap KGT pascaoperasi belum banyak dilakukan penelitian, sehingga penelitian ini bertujuan menilai korelasi ASMI praoperasi dengan KGT pascaoperasi. Metode: Studi observasional prospektif dilakukan pada subjek berusia 18 – 65 tahun di RS pendidikan tersier, RSUPN Dr. Cipto Mangunkusumo, yang dirawat untuk laparotomi elektif pada Maret sampai Juni 2023. Pengukuran ASMI praoperasi menggunakan bioimpedance analysis (BIA) multifrequency seca® mBCA 525 dengan cutoff laki-laki > 7,0kg/mg2 dan perempuan >5,7 kg/m2. Pengukuran KGT pada tangan kanan dan kiri pascaoperasi pada hari ke-6 pascaoperasi (POD-6) dengan dinamometer tangan spring-type CAMRY® dengan cutoff laki-laki >28 kg/m2 dan perempuan >18 kg/m2. Analisis bivariat dan multivariat digunakan untuk menilai hubungan variabel bebas dan terikat, serta mengidentifikasi faktor perancu yang berhubungan dengan KGT pascaoperasi. Hasil: Pada 85 subjek penelitian, sebanyak 98,82% subjek memiliki ASMI praoperasi rendah, 72,94% subjek memiliki KGT pascaoperasi tangan kanan menurun, dan 80% subjek memiliki KGT pascaoperasi tangan kiri menurun dari cutoff. Didapatkan hasil signifikan pada korelasi ASMI praoperasi dengan KGT pascaoperasi tangan kanan (r=0,444, p<0,001) dan kiri (r=0,423, p<0,001). Analisis lanjutan dengan regresi linier untuk faktor perancu didapatkan indeks massa tubuh (IMT) adalah faktor paling signifikan meningkatkan KGT tangan kanan dan kiri pascaoperasi. Kesimpulan: Terdapat hubungan yang bermakna secara statistik pada korelasi ASMI praoperasi dengan KGT pascaoperasi laparotomi elektif. ......Background: Laparotomy is a major surgery that can lead to a decrease in skeletal muscle mass and functional capacity, such as handgrip strength (HGS). Various studies have shown that HGS is decreasing after surgery can result in postoperative complications, and HGS is closely correlated with the appendicular skeletal muscle index (ASMI). Research on the preoperative influence of ASMI on postoperative HGS is limited, so this study aims to assess the correlation between preoperative ASMI and postoperative HGS. Top of Form Methods: A prospective observational study was conducted on subjects aged 18-65 years at the tertiary education hospital, RSUPN Dr. Cipto Mangunkusumo, who underwent elective laparotomy from March to June 2023. Preoperative ASMI measurements were taken using multifrequency bioimpedance analysis (BIA) with seca® mBCA 525, with a cutoff for males > 7.0 kg/m2 and females > 5.7 kg/m2. Postoperative HGS measurements for the right and left hands on postoperative day 6 (POD-6) were conducted using a spring-type hand dynamometer CAMRY® with a cutoff for males > 28 kg/m2 and females > 18 kg/m2. Bivariate and multivariate analyses were employed to assess the association between independent and dependent variables, as well as to identify confounding factors associated with postoperative HGS. Results: In 85 research subjects, 98.82% had low preoperative ASMI, 72.94% experienced a decrease in postoperative right HGS, and 80% had a decrease in postoperative left HGS from the cutoff. Significant results were obtained in the correlation between preoperative ASMI and postoperative right HGS (r=0.444, p<0.001) and left HGS (r=0.423, p<0.001). Further analysis with linear regression for confounding factors revealed that body mass index (BMI) was the most significant factor in increasing postoperative HGS for both right and left hands. Conclusion: There is a statistically significant in the correlation between preoperative ASMI and postoperative HGS in elective laparotomy.

Abstrak :
ABSTRAK
Obesitas merupakan penyakit tidak menular dimana lemak berlebih mengarah pada gangguan metabolik, penyakit kardiovaskular, dan perubahan abnormal biomekanik tubuh. Orang dengan obesitas memiliki kekuatan otot 6-10% lebih rendah dari orang dengan berat badan normal. Penurunan kekuatan otot sejalan dengan penurunan ruang gerak sendi, kontrol postural, dan kecepatan gerak yang dapat menyebabkan seseorang mengalami kendala dalam melakukan aktivitas fisik. Tujuan dari penelitian ini yaitu untuk mengetahui pengaruh Hatha Yoga selama 12 minggu terhadap persentase lemak, lingkar pinggang, kekuatan otot genggam, fleksibilitas, kesiembangan, dan kecepatan gerak pada orang dewasa dengan overweightdan obesitas.

Tujuh puluh dua orang dengan overweightdan obesitas, berusia 18-60 tahun, dirandomisasi ke dalam kelompok perlakuan (n=36) dan kelompok kontrol (n=36). Persentase lemak, lingkar pinggang, kekuatan otot genggam, fleksibilitas, keseimbangan, dan kecepatan gerak merupakan variabel yang diukur. Pemeriksaan yang sudah terstandarisasi dilakukan sebelum dan sesudah intervensi.

Terdapat perbedaan signifikan di antara kedua kelompok (semua p <0,001). Persentase lemak dan lingkar pinggang memberikan hasil dengan arah berlawanan. Kekuatan otot genggam, fleksibilitas, keseimbangan, dan kecepatan gerak membaik pada kelompok perlakuan. Sementara itu, fleksibilitas dan kecepatan gerak menurun secara siginifikan pada kelompok kontrol. Tidak dilaporkan adanya efek samping serius pada kedua kelompok.

Secara umum, program latihan Hatha yoga selama 12 minggu terbukti efektif dalam memperbaiki komponen antropometri dan fungsional pada orang dengan overweight dan obesitas. Penemuan ini memiliki makna implikasi klinis yang penting karena yoga dapat diimplementasikan sebagai salah satu alternatif aktivitas fisik.

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ABSTRACT
Obesity is a non-communicable disease in which excess body fat may lead to metabolic disorder, cardiovascular disease, and abnormal mechanics in body movements. Obese people have 6-10% less muscle-strength than those in the normal weight range. That decline in muscle-strength, along with similar declines in the range of movement of major joints, in postural control, and in the speed of movement may result in impaired ability to engage in physical activity. The purpose of this study is to investigate the effects on obese people of a 12-week Hatha yoga intervention--specifically focused on fat percentage, waist circumference, muscle strength, flexibility, balance, and gait speed.

Seventy-two overweight and obese people, aged 18-60 years, were randomly allocated to the yoga group (n=36) or to a "no exercise" control group (n=36). The fat percentage, waist circumference, handgrip strength, flexibility, balance, and gait speed were defined as outcome variables. Standardized tests were administered at baseline and post intervention.

There were significant differences between the two groups in regard to the outcome variables (all p <0.001). Predictably, fat percentage and waist circumference had moved in the other direction. Handgrip strength, flexibility, balance, and gait speed had significantly improved in the yoga group. Meanwhile, flexibility and gait speed significantly declined in the control group. No serious adverse events were reported in either group.

Overall, the 12-week Hatha yoga program was found to be effective in improving functional and anthropometric variables in obese people. The findings have important clinical implications since yoga may well serve as an alternative form of physical activity.

Abstrak :
ABSTRAK
Latar Belakang: Penilaian status gizi pada lanjut usia saat ini menggunakan Mini Nutritional Assessment MNA , namun memakan waktu yang cukup lama, dilakukan oleh tenaga kesehatan, dan tidak praktis bila digunakan di komunitas. Pemeriksaan kekuatan genggam tangan dapat dijadikan instrumen penapisan status gizi pada lanjut usia. Keuntungan dari pemeriksaan kekuatan genggam tangan antara lain sederhana, alatnya mudah dibawa, tidak membutuhkan waktu yang lama, praktis dan mudah digunakan oleh bukan tenaga kesehatan, tetapi belum ada data titik potong dan akurasi diagnosis kekuatan genggam tangan pada lanjut usia di komunitas.Tujuan: Mendapatkan titik potong dan akurasi diagnosis kekuatan genggam tangan sebagai penapis status gizi pada lanjut usia di komunitas.Metode: Penelitian potong lintang pada subjek berusia ge; 60 tahun di Posbindu di kecamatan Pulogadung, Jakarta Timur selama Januari-Februari 2017. Titik potong kekuatan genggam tangan dianalisis menggunakan kurva Receiver Operating Characteristics ROC . Akurasi diagnosis kekuatan genggam tangan dibandingkan dengan Mini Nutritional Assessment, dinilai dengan menghitung sensitivitas, spesifisitas, nilai duga positif NDP , nilai duga negatif NDN , rasio kemungkinan positif RKP , dan rasio kemungkinan negatif RKN .Hasil: Nilai Area Under the Curve AUC pada lanjut usia laki-laki dan perempuan adalah 90,5 IK95 82,0 ndash;99,0 dan 79,6 IK95 71,7 ndash;87,6 . Titik potong kekuatan genggam tangan lanjut usia laki-laki dan perempuan untuk mendeteksi kondisi malnutrisi berturut-turut adalah le; 25 kg dan le; 18 kg dengan sensitivitas 87,5 dan 77,8 , spesifisitas 80,0 dan 65,0 , NDP 66,7 dan 55,6 , NDN 93,3 dan 83,9 , RKP 4,4 dan 2,2, RKN 0,1 dan 0,3.Simpulan: Titik potong kekuatan genggam tangan lanjut usia laki-laki dan perempuan untuk mendeteksi malnutrisi berturut-turut adalah le; 25 kg dan le; 18 kg. Akurasi diagnosis kekuatan genggam tangan lanjut usia laki-laki dan perempuan dalam mendeteksi malnutrisi berturut-turut dinilai baik dan sedang.Kata Kunci: malnutrisi, lanjut usia, kekuatan genggam tangan, MNA ABSTRACT Backgound Assessment of elderly nutritional status using Mini Nutritional Assessment MNA may take longer time, should be performed by healthcare professional and not simple when using in community. Handgrip strength assessment could be a nutritional screening method for elderly. The benefits of using handgrip strength are simple, reliable, and easy performance method, but there is no sufficient information regarding its cutoffpoint and diagnostic accuracy for community living elderly.Objective To verify the cutoff point and accuracy of handgrip strength for nutritional assessment of community living elderly.Method A crossectional study was conducted at Posbindu in Pulogadung, Jakarta Timur in January February 2017. Subjects were men and women ge 60 years old. Cutoff point of malnutrition was analyzed by the ROC curve. Diagnostic accuracy of handgrip strength was calculated.Results The area under the curve AUC value of hand grip strength in elderly men and women were 90.5 CI 95 82.0 99.0 and 79.6 CI95 71.7 87.6 . Cutoff point of handgrip strength for diagnosis of malnutrition according to the reference standard were le 25 kg for men and le 18 kg for women, with the sensitivity, specificity, PPV, NPV, LR , and LR were 87.5 and 77.8 , 80.0 and 65.0 , 66.7 and 55.6 , 93.3 and 83.9 , 4,4 and 2,2, 0,1 and 0,3 for men and women, respectively.Conclusions Cutoff point of handgrip strength for diagnosis of malnutrition were le 25 kg for men and le 18 kg for women. Diagnostic accuracy of handgrip strength for diagnosis malnutrition in elderly men and women were good and moderate.